The Ralph Veterinary Referral Centre, Marlow, UK.
Department of Veterinary Medicine and Animal Sciences, University of Naples "Federico II", Naples, Italy.
Vet Surg. 2022 Jan;51(1):136-147. doi: 10.1111/vsu.13697. Epub 2021 Aug 9.
To report complications and prognostic factors in dogs undergoing proximal abducting ulnar osteotomy (PAUL). To evaluate the ability to predict complications on the basis of post-operative radiographic examination.
Retrospective cohort study.
Sixty-six dogs.
Medical records of dogs treated with PAUL between 2014 and 2019 were reviewed for demographics, intraoperative findings, and post-operative complications. Post-operative radiographs were reviewed by two masked expert orthopedic surgeons, who were asked to predict the likelihood of major mechanical complications. The prognostic value of variables was tested with univariate and multivariable logistic regression. Inter-investigator agreement to predict complications was evaluated with two-by-two tables and kappa coefficient.
Seventy-four PAULs in 66 dogs were included. Duration of follow-up ranged from 12 to 75 months (median: 53 months). Post-operative complications were documented in 19/74 limbs (16 dogs), including major complications in 13 limbs. These complications consisted mainly of non-union (six limbs), implant failure (two limbs), and infection (two limbs) requiring revision surgery in nine limbs. Body weight was the only variable associated with an increased risk of post-operative complications (p = .04). Agreement between expert predictions was low (respectively k = -0.08 and k = 0.11).
Major complications were reported in one fourth of limbs treated with PAUL and were more likely as body weight increased. Suboptimal plate and screw placement or osteotomy reduction on post-operative radiographs were poorly predictive of complications.
Complications are fairly common after PAUL, particularly in heavier dogs, and post-operative radiographic examination seems unreliable to predict those.
报告行近端尺骨外展截骨术（PAUL）的犬只的并发症和预后因素。评估基于术后影像学检查预测并发症的能力。
回顾性队列研究。
66 只狗。
回顾 2014 年至 2019 年间接受 PAUL 治疗的犬只的病历资料，包括人口统计学、术中发现和术后并发症。由两名经过培训的骨科专家对术后 X 光片进行评估，要求他们预测发生主要机械并发症的可能性。使用单变量和多变量逻辑回归测试变量的预后价值。使用四格表和 Kappa 系数评估两位评估者预测并发症的一致性。
纳入了 66 只狗的 74 个 PAUL。随访时间为 12 至 75 个月（中位数：53 个月）。19/74 个（16 只狗）肢体记录到术后并发症，9 个肢体需要进行翻修手术，包括 6 个肢体的非愈合、2 个肢体的植入物失败和 2 个肢体的感染。体重是唯一与术后并发症风险增加相关的变量（p=0.04）。专家预测的一致性较低（kappa 值分别为-0.08 和 0.11）。
行 PAUL 治疗的犬只中有四分之一出现了主要并发症，并且体重增加的犬只更容易出现并发症。术后 X 光片上的钢板和螺钉位置不当或截骨复位不佳对并发症的预测作用较差。
PAUL 术后并发症较为常见，尤其是在体重较大的犬只中，术后影像学检查似乎无法可靠地预测这些并发症。
